Author: Steven J. Spear
I found this to be an insightful book, a good overview of how the principles that made Toyota and its production system so successful become operational in various industries.
Spear describes the four capabilities of world-class companies that vault them ahead of their competitors and keep them a step or two ahead: designing and operating the system in a way that reveals knowledge about the best processes while making problems and inefficiencies visible; building knowledge by “swarming” and solving those problems; quickly disseminating the lessons learned throughout the entire organization; and developing the first three capabilities in those who lead.
The book carries relevance to me for a couple of reasons. Spear notes several situations where healthcare systems have successfully used these principles in improving quality and reducing patient harm. Also, my own organization is actively deploying “lean” processes to improve efficiency and outcomes; it’s good for me to have a connection point with the origin of some of the techniques of the lean leaders. (I see the author is scheduled to appear at the IHI National Forum next week. I look forward to the possibility of meeting him.)
As a healthcare professional without any exposure to auto manufacturing or any kind of factory work, parts of the book were dull for me – even though I understand the need to elucidate the details in illustrating the capabilities as they are practiced at Toyota and elsewhere, just as a manufacturer would find the excursions into healthcare boring. That said, I still found this to be a pleasant read, with judicious use of tables and diagrams to enhance comprehension. I recommend it to healthcare leaders and all others looking to improve their organization’s competitive edge.
Critical Condition 
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